Value Perceptions of Integrative Health Care: A Study of Primary Care Physicians and Professional Clinical Counselors

A study was conducted to identify value perceptions of primary care physicians and Professional Clinical Counselors on integrative health care. Surveys were collected from 54 primary care physicians and 33 Professional Clinical Counselors in Central Ohio. Quantitative and qualitative results indicate favorable perceptions and opportunities for professional collaboration.     

Help-Seeking from Clergy and Spiritual Counselors Among Veterans with Depression and PTSD in Primary Care

Little is known about the prevalence or predictors of seeking help for depression and PTSD from spiritual counselors and clergy. We describe openness to and actual help-seeking from spiritual counselors among primary care patients with depression. We screened consecutive VA primary care patients for depression; 761 Veterans with probable major depression participated in telephone surveys (at baseline, 7 months, and 18 months). Participants were asked about (1) openness to seeking help for emotional problems from spiritual counselors/clergy and (2) actual contact with spiritual counselors/clergy in the past 6 months. At baseline, almost half of the participants, 359 (47.2 %), endorsed being “very” or “somewhat likely” to seek help for emotional problems from spiritual counselors; 498 (65.4 %) were open to a primary care provider, 486 (63.9 %) to a psychiatrist, and 409 (66.5 %) to another type of mental health provider. Ninety-one participants (12 %) reported actual spiritual counselor/clergy consultation. Ninety-five (10.3 %) participants reported that their VA providers had recently asked them about spiritual support; the majority of these found this discussion helpful. Participants with current PTSD symptoms, and those with a mental health visit in the past 6 months, were more likely to report openness to and actual help-seeking from clergy. Veterans with depression and PTSD are amenable to receiving help from spiritual counselors/clergy and other providers. Integration of spiritual counselors/clergy into care teams may be helpful to Veterans with PTSD. Training of such providers to address PTSD specifically may also be desirable.     

Archetypal Identity Development,Meaning in Life,and Life Satisfaction: Differences Among Clinical Mental Health Counselors,School Counselors,and Counselor Educators

Adults pursuing careers in counselor education, clinical mental health counseling, and counselor education (N = 256) participated in a study that examined relationships among archetypal identity development, meaning in life, and life satisfaction. Significant differences between groups existed for 5 archetypal identities, and meaning in life was significantly related to life satisfaction.     

Intrapersonal and Organizational Factors Associated With Burnout Among School Counselors

This study investigated the demographic, intrapersonal, and organizational factors associated with burnout among a population of school counselors in the northeastern United States (n = 78). Three hierarchical regression analyses were completed to determine the amount of variance that each cluster contributed to the 3 subscales on the Maslach Burnout Inventory‐Educators Survey (MBI‐ES; C. M. Maslach, S. E. Jackson, & M. P. Leiter, 1996): Emotional Exhaustion, Depersonalization, and Personal Accomplishment. The final models accounted for 45%, 30%, and 42% of the overall variation on each subscale, respectively.     

Collaboration of Colorado Cancer Genetic Counselors to Integrate Next Generation Sequencing Panels into Clinical Practice

The recent introduction of clinically available next generation sequencing (NGS) cancer panels has presented new challenges for genetic counselors. Determining which patients are appropriate for NGS panel testing is complex. Due to the large number of genes included in the NGS panels, thorough and appropriate pre-test counseling and interpretation of NGS results can be a time-consuming and difficult process. Many of the genes associated with increased cancer risk lack published clinical management guidelines and estimates of cancer risk for individuals with deleterious mutations. In order to efficiently and effectively review the clinical utility of NGS panels, Colorado cancer genetic counselors formed a working group to gain a better understanding of the genes included in NGS cancer panels. This publication reports on the approach of this group, the process used to evaluate a selected NGS panel, future directions for this collaboration, and ideas for other genetic counselors to form similar groups to efficiently evaluate new technologies and improve practice.     

Performance of Mental Health Counselors in Integrated Primary and Behavioral Health Care

Integrated primary and behavioral health care (IPBH) is becoming a preferred mode of service delivery in the United States. Integrated care includes the participation of medical and mental health professionals, such as mental health counselors. The clinical outcomes of these professionals need to be studied to determine their effectiveness in such settings. We examined the performance of 10 mental health counselors on the clinical outcome of 1,747 clients treated in an IPBH center. Analyses using growth curve modeling and pre‐post test design revealed that mental health counselors were effective overall, but they differed in client dropout rates and efficiency in reducing clients' initial symptoms. We used the analyses to rank order counselors based on their effectiveness. Counselors who were the most effective varied in their efficiency but demonstrated the lowest client dropout rates. Implications for future research and counseling practice were discussed.     

Self‐Stigma of Mental Illness and Help Seeking Among School Counselors

The authors reported the findings from a correlational investigation examining the relationship between school counselors' (N = 333) self‐stigma of mental illness, help‐seeking behaviors, burnout, stress, and life satisfaction. The authors used a path analysis to test a hypothesized causal framework that self‐stigma of mental illness contributed to help‐seeking behaviors, which contributed to stress and burnout. The findings showed that the data fit the hypothesized model. The authors discuss the implications of the findings.     

Health Risk Behaviors and Their Relationships to Health Care Utilization Among Veterans Receiving Primary Medical Care

This paper reports the findings of a behavioral health risk screening form and examines the interrelationships among behavioral risk factors and health care utilization. Participants were 1,000 veterans who completed a brief self-report questionnaire assessing affective distress and behavioral health risk factors while they waited to see their primary care provider. Participants reported a mean level of affective distress in the mild range on a scale of 0 to 20 (M = 6.4, SD = 4.95), and 22.4% reported moderate or high levels of affective distress. Fifty percent of the sample denied alcohol use; 5% of the men and none of the women reported a pattern of use that met established criteria for at-risk drinking. Twenty-six percent of the sample reported current tobacco use, 45% acknowledged concerns about diet and/or weight, and 54% reported concern about pain. These factors were largely significantly intercorrelated and several were related to indices of health care utilization. It was concluded that veterans receiving health care in primary care settings report significant levels of affective distress and other health risk behaviors and that the presence of these factors is associated with increased use of the health care system. These data encourage increased efforts to identify these factors and to develop behavior change interventions.     

Needs and Preferred Style of Supervision Among Israeli School Counselors at Different Stages of Professional Development

The study aimed to identify differential needs for supervision and preferred roles and style of supervision among 202 Israeli school counselors with varied experience levels. Results of multivariate analysis of variance procedures indicated that counselors with 7 or fewer years of experience consistently expressed significantly higher needs on all but one of the items studied, compared with more experienced counselors and counselor supervisors. The counselor supervisors were also different from the more experienced counselors. By contrast, in respect of roles and style of supervision, there was more agreement across all 4 levels of experience; all counselors placed important values on the counseling, process, and personalization components, suggesting a basic need for growth-oriented supervision.     

职业压力、教学效能感与中小学教师职业倦怠的关系

以199名中小学教师为被试,采用典型相关研究的方法考察了职业压力、教学效能感与教师职业倦怠的关系。结果表明:(1)职业压力将导致中小学教师出现情绪衰竭和人格解体症状,职业压力越大,则职业倦怠的程度就越严重;(2)教师的教学效能感越低,则其情绪衰竭和人格解体的程度也将越严重;(3)教学效能感在职业压力与职业倦怠之间可能具有调节作用,高教学效能感可以改变职业压力的作用,减少"情绪衰竭"和"人格解体"的程度。     

加强中小学生无神论教育的四点建议

正如<科学与无神论>(2001年第五期)中<关于在青少年中开展科学无神论教育的讨论>的编者按所指出的一样:近十年来,神功异能、新有神论思潮的泛滥,在社会中产生了许多负面影响,特别是在青少年的身心发展及世界观、人生观的形成上,产生直接的影响,使他们特别热衷于多种神秘事物的追逐.要改变这种局面,为青少年的健康成长提供一个科学的空间,笔者以为要从以下四个方面加强对中小学生的无神论教育.     

Examining Factors Associated with Primary Care and Continuity of Care Among Adults with Severe Mental Illness

A number of studies have consistently reported that there is a greater prevalence of mental illness among the most socioeconomically disadvantaged. At the same time, there is evidence that services are not optimally accessed by the most socioeconomically disadvantaged; the most in need of care are also the most likely to have unmet healthcare needs. Of people with mental illnesses, those with severe mental illnesses (SMI) are the most at risk of poverty and the least likely to have optimal care. In the past, specialized community mental health services have been identified as the primary provider for people with SMI. However, there is growing interest in using the primary care setting as the main source of mental health care where both medical treatment and psychotherapy can be accessed. In this paper, we examine factors related to primary care use (and in turn, pharmacologic and psychotherapies) for people who are socioeconomically disadvantaged and who have a SMI.     

The Experience of Ethical Dilemmas,Burnout, and Stress Among Practicing Counselors

The authors reported findings from a correlational investigation examining the relationship between counselors' (N = 140) experiences with ethical dilemmas and their reported levels of burnout and stress. Using structural equation modeling, the authors identified that a higher rate of encountering ethical dilemmas related to an increased level of counselor burnout and stress among the participants. However, higher rates of reflecting on the ethical dilemmas did not have a relationship with participants' burnout and stress. The authors present implications of these findings for counselors, along with future research directions.     

The Personal and Social Correlates of Spiritual Well-Being Among Primary School Teachers

A sample of 311 primary school teachers completed the Spiritual Health in Four Domains Index alongside the abbreviated revised Eysenck Personality Questionnaire and measures of religiosity. The data demonstrate that higher levels of spiritual health are found among older teachers who record low scores on the psychoticism scale and who practice religious faith through church attendance and personal prayer.     

Using the Internet to Enhance Testing in Counseling

This article reviews potential Internet applications in test selection, orientation, administration, scoring, and interpretation and explores inappropriate assessment use, relationship issues, ethics, credentialing, and training.     

Perfectionism and School Counselors: Differences in Stress,Coping, and Burnout

The authors examined perfectionism and its association with perceived stress, coping processes, and burnout in a sample of 298 practicing school counselors. Latent profile analysis based on measures of perfectionism supported a 3‐class model made up of adaptive perfectionists, maladaptive perfectionists, and nonperfectionists. Among these groups, the authors found significant differences in perceived stress, coping processes, and burnout. Implications for the school counseling profession are discussed.     

Behavior Problems, Academic Skill Delays and School Failure Among School-Aged Children in Foster Care: Their Relationship to Placement Characteristics

We describe the level of behavior problems, academic skill delays, and school failure among school-aged children in foster care. We also examine how behavior problems are associated with academic problems, and explore how these outcomes are related to children's placement characteristics. Foster parent and child home interviews, as well as teacher telephone interviews were conducted from a randomly selected sample of 302 children aged 6 through 12 years living in out-of-home placement. Interviews included standardized screening measures. Results showed that 27% of the children scored in the clinical range for a behavior problem, and 34% were rated as having at least one behavior problem in the classroom. Twenty-three percent of the children had severe delays in reading or math, 13% had repeated a grade, and 14% had a history of school suspension and/or expulsion. Behavior problems by foster parent report were related to child suspension and/or expulsion from school, but were not associated with severe academic delays or grade retention. Placement characteristics were only sometimes related to these outcomes. Future studies examining the mental health and educational needs of this population should take into account the child's sociodemographic and placement characteristics.